<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<title>提现</title>
<meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1">
<meta name="format-detection" content="telephone=no">
<script src="../js/flexible.js"></script>
<link href="../css/icons.css" rel="stylesheet" type="text/css">
<link rel="stylesheet" type="text/css" href="../css/base.css" />
<link rel="stylesheet" type="text/css" href="../css/member.css" />
</head>
<body class="login">
<div class="head">
	<button class="md-close back"><i class="iconfont">&#xe617</i></button>
	<a href="#" class="md-login floatRgt">
	登录
	</a>
	<h2 >提现</h2>
</div>
<div class="bannerico"><i class="iconfont">&#xe638</i></div>
<div class="page member">
	<form id="withdraw" class="mlogin " action="" method="post">
		<div class="field">
			<div class="label">
				姓名
			</div>
			<div class="field-control">
				<input type="text" class="input-required" name="name" placeholder="请输入您的直实姓名" value="" id="name">
			</div>
		</div>
		<div class="field">
			<div class="label">
				所属银行
			</div>
			<div class="field-control">
				<input type="text" class="input-required" name="bank" placeholder="请输入您的持卡银行" value="" id="bank">
			</div>
		</div>
		<div class="field">
			<div class="label">
				银行卡号
			</div>
			<div class="field-control">
				<input type="text" class="input-required input-tip" name="card" placeholder="请输入您银行卡号" value="" id="card">
			</div>
		</div>
		<div class="field">
			<div class="label">
				开户地址
			</div>
			<div class="field-control">
				<input type="text" class="input-required" name="card" placeholder="请输入您银行卡开户地址" value="" id="card">
			</div>
		</div>
		<div class="submit submitdown">
			<button type="submit" class="button " id="submit-btn">提 交</button>
		</div>
	</form>
</div>
</body>
</html>